For a number of years, pharmaceutical manufacturers have provided patients with personalized marketing services and programs designed to encourage product adoption or promote continued use of their brand medications. These services and programs have included, for example, rebates, point-of-sale free product samples, ATM gift cards, educational mailings and refill reminders. The impact of these programs is diminished, however, when accurate and timely information on the patient's use of the medication before and after the service is unavailable.
Marketing service providers have been unable to directly link any of the above services with a patient's prescription fill history unless they are also a pharmacy, PBM (Pharmacy Benefits Manager) or health plan. These organizations have visibility to their own customer or membership's prescription claim transaction data and can perform educational or other interventional activities in response to prescription fulfillment behavior. They can also measure the impact of those particular activities on subsequent patient prescription utilization. Unfortunately, their reach over a cross-section of a brand pharmaceutical market is limited.
Independent marketing service providers not associated with a particular third-party payer or pharmacy, have alternatively collected prescription utilization information directly from patients in order to trigger marketing services. The methodologies used to capture prescription transaction information, however, may be inadequate to capture timely, accurate and relevant information. Independent marketing service providers do have the ability to access historical prescription data via third party resellers and match it with the specific population of patients participating in a marketing program to measure the impact of their marketing activities. While this data can be meaningful and significant, manufacturers may perceive it to be incomplete or inferior because not all pharmacy transactions are sold to these third parties.
Also for a number of years, pharmaceutical companies have expanded upon the practice of donating free samples of brand medications to physicians for distribution to patients by directly providing patients with mail-in rebates and electronic rebates at the point of sale (provided via certain sample vouchers). More recently, companies have followed trends from other consumer markets by providing monetary incentives in the form of debit “gift” cards or credit card mechanisms.
The incentives provided by these cards have not been linked to the fulfillment of the associated prescription, and in many cases consumers have used the cards to purchase non-pharmaceutical items at their drug retailer or elsewhere. In addition, fraudulent use of the cards has been cited including examples of using the entire balance on a debit card for one (rather than the intended multiple) prescription transaction. This type of abuse is currently being addressed through “instant rebate” debit card programs that allow for only one rebate per store transaction, but the systems and data are still de-linked from the prescription dispensing event. Similar misuse has been experienced with credit card instruments.
In addition to the fraud and abuse issues, monetary incentives for prescription fulfillment have been limited to a uniform value for a particular product offer. For insured patients, pharmaceutical marketers have sought the ability to vary the incentives based upon the individual patient's co-pay amount, which can vary considerably across prescription benefit plans based upon individual patient coverage, cost sharing tiers, drug formulary design, and plan exclusions. To date, no solutions have been identified to address this variability in patient cost-share amounts on a patient-specific basis in real time using the mail-in rebate, debit card or credit card mechanisms.